Sociology
Section 4: Health in Practice
The BPS Model
The BPS Paradigm in Health Sciences
• The BPS paradigm, introduced by Engel in 1977, aims to integrate aspects of
the Biological Medicine (BM) and the Psychosocial Theory (PSE) model into
everyday healthcare.
• Critics argue that individual components like lifestyle, psychology, and
genetics often hinder the incorporation of PSE dimensions into mainstream BM
discourse and practice.
• The BPS model can be applied as practical skills to improve the quality of
healthcare provided to patients.
• Physicians selectively use the BPS model to understand disease processes,
improve physician-patient relations, and manage chronic illnesses.
• The reluctance to incorporate the BPS and definitive health standards is often
psychosocial.
• The BPS model enhances the context within which healthcare services are
delivered and practitioners work.
• It introduces insights and skills to healthcare practitioners that would usually
be learned tacitly on the job and over time.
• Challenges faced by junior doctors include cultivating an 'elective affinity' in
the patient as an individual, not a stereotype.
• The BPS model is built on human understanding relations and focuses on
understanding the complexity of disease causation, engaging the power and
emotions embedded in the healthcare practitioner-patient model.
• The use of the BPS model requires practitioners to develop greater ability and
invest more in human and capital resources
Healthcare Practices and Psycho-Social Approaches
• Engel (1978) highlights the importance of reflexive and flexible healthcare
relationships, patient autonomy in decision-making, empathetic healthcare, and
constructive care.
• Borrell-Carrió et al. formulate seven key responsibilities for contemporary
healthcare practitioners:
1. calibrating the physician,
2. creating trust,
1
, 3. cultivating creativity,
4. recognizing bias,
5. educating emotions,
6. using informed intuition,
7. and communicating clinical evidence.
• These responsibilities build a dynamic and caring healthcare system for
patients, their 'community of carers', all healthcare practitioners, and the
community.
• The biopsycho-social model (BPS model) and the psycho-social approach (PSE
model) are often overlooked in tertiary healthcare education due to the
historical power of biomedical dominance.
• Health sciences show a wide variety of ideologies and practices, including the
BM, BPS model, and PSE model.
• These disciplines make up distinct specialties and/or disciplinary pockets in
other areas.
• Global trends in disease epidemiology and the shift towards healthiest have
recast how health is conceived and practiced.
• South Africa's unique health and healthcare experiences, with high rates of
infectious and non-communicable diseases, require health science students and
practitioners to be activists for social justice and equality.
New Challenges in the New Millennium
A. Global Health Progress and Challenges
• The World Health Organisation (WHO) affirmed its constitutional goal for
'health for all' and the highest attainable standard of health as a
fundamental human right.
• Technological advancements in biotechnology, information technology,
digital media, and telemedicine have shown great potential for disease
prevention and treatment.
• Breakthroughs have been seen in chronic health with targeted cancer
treatment, combined antiretroviral treatment for HIV/AIDS, prevention and
better intervention in heart disease and heart attacks, improved clarity on
risks associated with hormone replacement therapy, and through the
successes of the antismoking lobby
B. Globalisation and Health
• Globalisation has offered a range of innovations in commerce, research,
and development, and contributed to the unprecedented exchange of
values, ideas, trade, travel, and disease.
• There has been unprecedented growth in domestic health, affecting the
potential, scope, and actual practice of shared knowledge and healthcare
practices across the globe.
2
, • Despite these creative and constructive potential, inequities connected
to social, cultural, political, and economic maldistribution of resources are
still present.
C. Role of Patient Forums and Online Discussion Forums
• The role of the 'patient' and the relationship between the healthcare
practitioner and patient have changed fundamentally due to patients'
access to and use of the internet and online discussion forums.
• Online forums have also reflected political concerns such as campaigns
around HIV/AIDS, LGBTIAQ+, Black Lives Matter, and March for our Lives.
D. Crisis of Service Delivery and Socio-economic Inequalities
• The potential and achievements of the twentieth and twenty-first
centuries have been coupled with crises of service delivery, vast socio-
economic inequalities, and deteriorating health conditions worldwide.
• Urbanisation, internal and cross-border migration, an ageing
demographic profile with gaps in the ‘middle,' and increasing awareness
of, and threats of, environmental crisis were documented as key concerns
of the new millennium.
E. South Africa's Health Challenges
• Post-apartheid South Africa faced many of these generic global
hardships, but also faced its own needs and specific demands in providing
treatment and care for patients. The impact of HIV/AIDS, chronic illnesses,
injuries sustained from accidents, violence, and trauma, coupled with the
active underdevelopment of most of the country's population, takes its toll
on all sectors of society.
South African Healthcare Education and Practice
• South African healthcare context offers diverse training and occupational
potential for healthcare practitioners.
• Social inequalities, chronicity, and cultural diversity are fundamental
3
Section 4: Health in Practice
The BPS Model
The BPS Paradigm in Health Sciences
• The BPS paradigm, introduced by Engel in 1977, aims to integrate aspects of
the Biological Medicine (BM) and the Psychosocial Theory (PSE) model into
everyday healthcare.
• Critics argue that individual components like lifestyle, psychology, and
genetics often hinder the incorporation of PSE dimensions into mainstream BM
discourse and practice.
• The BPS model can be applied as practical skills to improve the quality of
healthcare provided to patients.
• Physicians selectively use the BPS model to understand disease processes,
improve physician-patient relations, and manage chronic illnesses.
• The reluctance to incorporate the BPS and definitive health standards is often
psychosocial.
• The BPS model enhances the context within which healthcare services are
delivered and practitioners work.
• It introduces insights and skills to healthcare practitioners that would usually
be learned tacitly on the job and over time.
• Challenges faced by junior doctors include cultivating an 'elective affinity' in
the patient as an individual, not a stereotype.
• The BPS model is built on human understanding relations and focuses on
understanding the complexity of disease causation, engaging the power and
emotions embedded in the healthcare practitioner-patient model.
• The use of the BPS model requires practitioners to develop greater ability and
invest more in human and capital resources
Healthcare Practices and Psycho-Social Approaches
• Engel (1978) highlights the importance of reflexive and flexible healthcare
relationships, patient autonomy in decision-making, empathetic healthcare, and
constructive care.
• Borrell-Carrió et al. formulate seven key responsibilities for contemporary
healthcare practitioners:
1. calibrating the physician,
2. creating trust,
1
, 3. cultivating creativity,
4. recognizing bias,
5. educating emotions,
6. using informed intuition,
7. and communicating clinical evidence.
• These responsibilities build a dynamic and caring healthcare system for
patients, their 'community of carers', all healthcare practitioners, and the
community.
• The biopsycho-social model (BPS model) and the psycho-social approach (PSE
model) are often overlooked in tertiary healthcare education due to the
historical power of biomedical dominance.
• Health sciences show a wide variety of ideologies and practices, including the
BM, BPS model, and PSE model.
• These disciplines make up distinct specialties and/or disciplinary pockets in
other areas.
• Global trends in disease epidemiology and the shift towards healthiest have
recast how health is conceived and practiced.
• South Africa's unique health and healthcare experiences, with high rates of
infectious and non-communicable diseases, require health science students and
practitioners to be activists for social justice and equality.
New Challenges in the New Millennium
A. Global Health Progress and Challenges
• The World Health Organisation (WHO) affirmed its constitutional goal for
'health for all' and the highest attainable standard of health as a
fundamental human right.
• Technological advancements in biotechnology, information technology,
digital media, and telemedicine have shown great potential for disease
prevention and treatment.
• Breakthroughs have been seen in chronic health with targeted cancer
treatment, combined antiretroviral treatment for HIV/AIDS, prevention and
better intervention in heart disease and heart attacks, improved clarity on
risks associated with hormone replacement therapy, and through the
successes of the antismoking lobby
B. Globalisation and Health
• Globalisation has offered a range of innovations in commerce, research,
and development, and contributed to the unprecedented exchange of
values, ideas, trade, travel, and disease.
• There has been unprecedented growth in domestic health, affecting the
potential, scope, and actual practice of shared knowledge and healthcare
practices across the globe.
2
, • Despite these creative and constructive potential, inequities connected
to social, cultural, political, and economic maldistribution of resources are
still present.
C. Role of Patient Forums and Online Discussion Forums
• The role of the 'patient' and the relationship between the healthcare
practitioner and patient have changed fundamentally due to patients'
access to and use of the internet and online discussion forums.
• Online forums have also reflected political concerns such as campaigns
around HIV/AIDS, LGBTIAQ+, Black Lives Matter, and March for our Lives.
D. Crisis of Service Delivery and Socio-economic Inequalities
• The potential and achievements of the twentieth and twenty-first
centuries have been coupled with crises of service delivery, vast socio-
economic inequalities, and deteriorating health conditions worldwide.
• Urbanisation, internal and cross-border migration, an ageing
demographic profile with gaps in the ‘middle,' and increasing awareness
of, and threats of, environmental crisis were documented as key concerns
of the new millennium.
E. South Africa's Health Challenges
• Post-apartheid South Africa faced many of these generic global
hardships, but also faced its own needs and specific demands in providing
treatment and care for patients. The impact of HIV/AIDS, chronic illnesses,
injuries sustained from accidents, violence, and trauma, coupled with the
active underdevelopment of most of the country's population, takes its toll
on all sectors of society.
South African Healthcare Education and Practice
• South African healthcare context offers diverse training and occupational
potential for healthcare practitioners.
• Social inequalities, chronicity, and cultural diversity are fundamental
3
